Faculty

Medel Paguirigan

Clinical Associate Professor

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Professional overview

Dr. Medel S. Paguirigan has been a nurse for more than 30 years. He has clinical experience in critical care and nephrology nursing (Certified Nephrology Nurse) in both the adult and pediatric populations. Dr. Paguirigan has been a nurse educator in both academic and acute care settings. He began his career as a nurse educator in academia as a Clinical Instructor at New York University’s College of Nursing (NYUCN). At NYUCN he taught didactic and clinical classes in the undergraduate program for both adult and pediatric curricula. Dr. Paguirigan was one of the faculty members who pioneered, taught, and integrated simulation technology in the adult and elder nursing curricula to supplement the off-campus clinical experience among undergraduate students.

As an educator in the acute care setting at the Mount Sinai Hospital (MSH) and Mount Sinai St. Luke’s (MSSL), Dr. Paguirigan developed more than 70 credits of Continuing Education, to enable the learning needs of the nursing and support staff. He integrated quality measures of performance in delivering care that puts emphasis on patient experience and other nurse sensitive indicators such as falls, pressure injuries, hospital-acquired infections, and nurse engagement. He introduced concept-based learning and used audience-response system for orientation and other educational offerings. Dr. Paguirigan integrated simulation as a teaching methodology in developing the Ebola Readiness and Preparedness training for more than 30 nurses at MSH campus, as well as the Mock Code for nursing and support staff (MSSL). Dr. Paguirigan originated the first “Transitions Program” in 2012 at MSH. Modeled after the Nurse Residency Program, the Transitions Program is a program for new graduate nurses to provide a seamless transition from being a student to assuming a professional role. He developed educational programs to address the knowledge, skill, and affective needs of new graduates. Dr. Paguirigan maintained 91% retention rate for two years, while the rest of the nation averaged 65%.

Additionally, Dr. Paguirigan was a member of the Magnet Redesignation Committee on New Knowledge, Innovation and Improvement that earned The Mount Sinai Hospital its 3rd Magnet redesignation. He also participated in the triennial Joint Commission Designation for both campuses. As the NICHE Coordinator, Dr. Paguirigan initiated Mount Sinai St. Luke’s Early Implementation of NICHE Designation.

Dr. Paguirigan believes in the humanities and the power of art for the development of the whole person. He obtained his early music training when he was six, with his mother as his first music teacher. Currently, in his spare time, Dr. Paguirigan is involved in New York’s art scene, choral music, and film production. As a bass baritone, he has performed with the choral organizations in New York City including Collegiate Chorale, Cantori New York, and New York Choral Society, which has a broad range of repertoire from classic and contemporary, to operas in concert. As a chorus member, he has performed with the stars of the Metropolitan Opera, Andrea Bocelli, and other notable soloists. Dr. Paguirigan collaborated with a fellow NYU colleague and an award-winning Philippine director, Joseph Israel Laban to produce a short film, “Antipo” that was accepted in the Court Metrage competition at the 63rd Cannes Film Festival in France. As a summer resident of Fire Island, New York, he actively supports the Arts Project of Cherry Grove.

Publications

Publications

Delivering LGBTQ-sensitive care

Members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community have historically faced prejudices, often resulting in significant health disparities. Critical care nurses have a duty to provide all patients, regardless of their sexual orientation or gender identity, with the best possible care. This article examines a framework for LGBTQ-sensitive care as well as best practices and additional resources.

Sacrificing something important: the lived experience of compensated kidney donors in the Philippines.

The sale of solid organs is illegal in many countries, but the reality is that it happens. This study investigated and identified the structure of sacrificing something important among compensated kidney donors in the Philippines by conducting in-depth, face-to-face dialogues from 13 participants in the town of Baseco, Manila, Philippines. The structure of sacrificing something important among compensated kidney donors emerges from the extrinsic intent of adversity and the intrinsic intent of altruism, which is instrumental to the struggle of making a difficult decision, emerging in the act with reciprocation, and although resulting in the consequences of health deterioration and loss, resilience makes bouncing back possible.

How well is hypertension controlled in CAPD patients?

To determine how well hypertension is controlled in continuous ambulatory peritoneal dialysis (CAPD) patients, we monitored the blood pressure of 31 hypertensive adult CAPD patients treated with antihypertensive agents. Blood pressure (BP) monitoring, using a noninvasive, ambulatory BP monitor, began in the morning and continued every 30-60 min for 24 h (mean 42 readings per patient). The mean BP of all patients over 24 h was 145.6/91.3 mm Hg. In these, 40.5% of systolic BP readings exceeded 150 mm Hg and 50.2% of diastolic readings exceeded 90 mm Hg, suggesting that hypertension was inadequately controlled for a considerable period of time. Diabetic patients had even worse control of BP. Mean BP, heart rates, and BP loads were not different, between daytime or nighttime. These findings suggest that CAPD patients do not preserve the normal circadian rhythm of BP and that their hypertension is not controlled any better during the night than during the day. We repeated BP monitoring after adjustment of antihypertensive medications in 8 patients who had poorly controlled hypertension. Systolic and diastolic BP loads in subsequent studies improved significantly from the first study. In conclusion: hypertension is suboptimally controlled in most CAPD patients; diabetic patients fare even worse in the control of hypertension; most patients do not preserve the circadian rhythm of BP and there is no difference in the adequacy of hypertension control during the day or at night; assessment of hypertension with ambulatory BP monitoring helps guide therapy and control of hypertension.